Code List: CMS69v6, Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up

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Item	Codes
Encounter Codes
Encounter, Performed: BMI Encounter Code Set: HCPCS	G0101, G0108, G0270, G0271, G0402, G0438, G0439, G0447
Encounter, Performed: BMI Encounter Code Set: CPT	90791, 90792, 90832, 90834, 90837, 96150, 96151, 96152, 97161, 97162, 97163, 97165, 97166, 97167, 97802, 97803, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99385, 99386, 99387, 99395, 99396, 99397
Encounter, Performed: BMI Encounter Code Set: SNOMED	8411005, 10197000, 13607009, 14736009, 18512000, 30346009, 32537008, 35025007, 37894004, 46662001, 55162003, 68381003, 78318003, 83607001, 86013001, 90526000, 108220007, 108221006, 108224003, 108311000, 165171009, 185349003, 185463005, 185465003, 225967005, 270427003, 270430005, 308335008, 386372009, 390906007, 406547006, 410155007, 410157004, 410158009, 410160006, 410170008, 410172000
Encounter, Performed: BMI Encounter Code Set: CDT	D7140, D7210
Intervention (Above Normal) Codes
Intervention, Order: Above Normal Follow-up: HCPCS	G0270, G0271, G0447, G0473, S9449, S9451, S9452, S9470
Intervention, Order: Above Normal Follow-up: CPT	43644, 43645, 43659, 43770, 43771, 43772, 43773, 43774, 43842, 43843, 43845, 43846, 43847, 43848, 43886, 43888, 97802, 97803, 97804, 98960, 99078, 99401, 99402
Intervention, Order: Above Normal Follow-up: SNOMED	304549008, 307818003, 361231003, 370847001, 386291006, 386292004, 386373004, 386463000, 386464006, 410177006, 413315001, 418995006, 424753004, 443288003
Intervention (Below Normal) Codes
Intervention, Order: Below Normal Follow up: HCPCS	G8418, S9449, S9452, S9470
Intervention, Order: Below Normal Follow up: SNOMED	386464006, 410177006, 413315001, 418995006, 424753004, 429095004, 443288003
Intervention, Order: Below Normal Follow up: ICD-10	Z71.3
Intervention (Referral) Codes
Intervention, Order: Referrals where weight assessment may occur: SNOMED	91251008, 103698003, 103699006, 183515008, 183524004, 183583007, 185359002, 305922005, 306136006, 306163007, 306164001, 306165000, 306166004, 306167008, 306168003, 306226009, 306227000, 306252003, 306344004, 306353006, 306354000, 308459004, 308470006, 308477009, 390864007, 390866009, 390893007, 408289007, 410160006, 416790000, 424203006
Intervention Medications
Medication, Order: Above Normal Medications: Description (RXNORM code)	24 HR Diethylpropion Hydrochloride 75 MG Extended Release Oral Tablet (978668); 24 HR lorcaserin hydrochloride 20 MG Extended Release Oral Tablet (1808549); 24 HR Phentermine 11.25 MG / topiramate 69 MG Extended Release Oral Capsule (1313059); 24 HR Phentermine 15 MG / topiramate 92 MG Extended Release Oral Capsule (1302850); 24 HR Phentermine 3.75 MG / topiramate 23 MG Extended Release Oral Capsule (1302839); 24 HR Phentermine 7.5 MG / topiramate 46 MG Extended Release Oral Capsule (1302827); Diethylpropion Hydrochloride 25 MG Oral Tablet (978654); lorcaserin hydrochloride 10 MG Oral Tablet (1300706); orlistat 120 MG Oral Capsule (314153); orlistat 60 MG Oral Capsule (692876); Phentermine Hydrochloride 15 MG Disintegrating Oral Tablet (1112982); Phentermine Hydrochloride 15 MG Oral Capsule (968766); Phentermine Hydrochloride 18.8 MG Oral Capsule (826131); Phentermine Hydrochloride 30 MG Disintegrating Oral Tablet (1112987); Phentermine Hydrochloride 30 MG Oral Capsule (900038); Phentermine Hydrochloride 37.5 MG Disintegrating Oral Tablet (1249083); Phentermine Hydrochloride 37.5 MG Oral Capsule (803348); Phentermine Hydrochloride 37.5 MG Oral Tablet (803353); Phentermine Hydrochloride 8 MG Oral Tablet (826919)
Medication, Order: Below Normal Medications: Description (RXNORM code)	Megestrol Acetate 125 MG/ML Oral Suspension (577154); Megestrol Acetate 160 MG Oral Tablet (860231); Megestrol Acetate 20 MG Oral Tablet (860215); Megestrol Acetate 40 MG Oral Tablet (860221); Megestrol Acetate 40 MG/ML Oral Suspension (860225); Tetrahydrocannabinol 10 MG Oral Capsule (197634); Tetrahydrocannabinol 2.5 MG Oral Capsule (197635); Tetrahydrocannabinol 5 MG Oral Capsule (197636)
Exception Reasons
Intervention or Medication, Order not done: Medical or Other reason not done: SNOMED	Procedure contraindicated (183932001), Medical contraindication (397745006), Treatment not tolerated (407563006), Procedure not indicated (428119001)
Palliative Care Exclusion Codes
Intervention, Order: Palliative Care: SNOMED	103735009, 133918004, 182964004, 305284002, 305381007, 305981001, 306237005, 306288008, 385736008, 385763009
Encounter, Performed: Palliative care encounter: ICD-10	Z51.5
Exclusions for Not Completing Exam
Physical Exam, Performed not done: Patient Reason Refused: SNOMED	Refusal of treatment by patient (105480006), Procedure refused (183944003), Procedure refused for religious reason (183945002), Patient non-compliant – refused access to services (413310006), Patient non-compliant – refused intervention / support (413311005), Patient non-compliant – refused service (413312003)
Exclusion Diagnosis Codes
Diagnosis: Pregnancy Dx: ICD-10	A34, O00.00, O00.01, O00.101, O00.102, O00.109, O00.111, O00.112, O00.119, O00.201, O00.202, O00.209, O00.211, O00.212, O00.219, O00.80, O00.81, O00.90, O00.91, O01.9, O02.0, O02.1, O03.0, O03.1, O03.2, O03.30, O03.31, O03.32, O03.33, O03.34, O03.37, O03.39, O03.4, O03.5, O03.6, O03.7, O03.80, O03.81, O03.82, O03.83, O03.84, O03.85, O03.86, O03.87, O03.88, O03.89, O03.9, O04.5, O04.6, O04.7, O04.80, O04.81, O04.82, O04.83, O04.84, O04.85, O04.86, O04.87, O04.88, O04.89, O07.0, O07.1, O07.2, O07.30, O07.31, O07.32, O07.33, O07.34, O07.35, O07.36, O07.37, O07.38, O07.39, O07.4, O08.0, O08.1, O08.2, O08.3, O08.4, O08.5, O08.6, O08.7, O08.81, O08.82, O08.83, O08.89, O08.9, O09.00, O09.10, O09.11, O09.12, O09.13, O09.211, O09.291, O09.30, O09.40, O09.41, O09.42, O09.43, O09.511, O09.512, O09.513, O09.519, O09.521, O09.522, O09.523, O09.529, O09.611, O09.621, O09.819, O09.821, O09.822, O09.823, O09.829, O09.891, O09.892, O09.893, O09.899, O09.90, O09.91, O09.92, O09.93, O09.A0, O09.A1, O09.A2, O09.A3, O10.011, O10.012, O10.013, O10.019, O10.03, O10.111, O10.112, O10.113, O10.119, O10.12, O10.13, O10.211, O10.212, O10.213, O10.219, O10.22, O10.23, O10.311, O10.312, O10.313, O10.319, O10.32, O10.33, O10.411, O10.412, O10.413, O10.419, O10.42, O10.43, O10.911, O10.912, O10.913, O10.919, O10.92, O10.93, O11.1, O11.2, O11.3, O11.4, O11.5, O11.9, O12.00, O12.01, O12.02, O12.03, O12.04, O12.05, O12.10, O12.11, O12.12, O12.13, O12.20, O12.21, O12.22, O12.23, O12.24, O12.25, O13.1, O13.2, O13.3, O13.4, O13.5, O13.9, O14.00, O14.02, O14.03, O14.04, O14.05, O14.10, O14.12, O14.13, O14.14, O14.15, O14.20, O14.22, O14.23, O14.24, O14.25, O14.90, O14.92, O14.93, O14.94, O14.95, O15.02, O15.03, O15.1, O15.2, O16.1, O16.2, O16.3, O16.4, O16.5, O16.9, O20.0, O20.8, O20.9, O21.0, O21.2, O21.8, O21.9, O22.00, O22.01, O22.02, O22.03, O22.10, O22.11, O22.12, O22.13, O22.20, O22.21, O22.22, O22.23, O22.30, O22.31, O22.32, O22.33, O22.40, O22.41, O22.42, O22.43, O22.50, O22.51, O22.52, O22.53, O22.90, O22.91, O22.92, O22.93, O23.00, O23.10, O23.20, O23.30, O23.40, O23.41, O23.42, O23.43, O23.519, O23.529, O23.599, O23.90, O23.91, O23.92, O23.93, O24.319, O24.32, O24.415, O24.419, O24.425, O24.429, O24.435, O24.439, O24.911, O24.912, O24.913, O24.92, O24.93, O25.10, O25.11, O25.12, O25.13, O25.2, O25.3, O26.00, O26.01, O26.02, O26.03, O26.11, O26.12, O26.13, O26.20, O26.21, O26.22, O26.23, O26.41, O26.42, O26.43, O26.50, O26.51, O26.52, O26.53, O26.611, O26.612, O26.613, O26.619, O26.62, O26.811, O26.812, O26.813, O26.819, O26.821, O26.822, O26.823, O26.829, O26.831, O26.832, O26.833, O26.839, O26.841, O26.842, O26.843, O26.849, O26.851, O26.852, O26.853, O26.859, O26.872, O26.873, O26.879, O26.891, O26.892, O26.893, O26.899, O26.90, O30.001, O30.002, O30.003, O30.009, O30.021, O30.022, O30.023, O30.029, O30.101, O30.102, O30.103, O30.109, O30.201, O30.202, O30.203, O30.209, O30.801, O30.802, O30.803, O30.809, O30.90, O30.91, O30.92, O30.93, O33.0, O33.1, O33.2, O33.7XX0, O33.7XX1, O33.7XX2, O33.7XX3, O33.7XX4, O33.7XX5, O33.7XX9, O33.8, O33.9, O34.00, O34.01, O34.02, O34.03, O34.10, O34.11, O34.12, O34.13, O34.211, O34.212, O34.219, O34.29, O34.30, O34.31, O34.32, O34.33, O34.40, O34.41, O34.42, O34.43, O34.511, O34.512, O34.513, O34.519, O34.521, O34.522, O34.523, O34.529, O34.531, O34.532, O34.533, O34.539, O34.591, O34.592, O34.593, O34.599, O34.60, O34.61, O34.62, O34.63, O34.70, O34.71, O34.72, O34.73, O34.80, O34.81, O34.82, O34.83, O34.90, O34.91, O34.92, O34.93, O35.7XX0, O35.7XX1, O35.7XX2, O35.7XX3, O35.7XX4, O35.7XX5, O35.7XX9, O35.8XX0, O35.8XX1, O35.8XX2, O35.8XX3, O35.8XX4, O35.8XX5, O35.8XX9, O36.0110, O36.0120, O36.0130, O36.0190, O36.0910, O36.0920, O36.0930, O36.0990, O36.1110, O36.1120, O36.1130, O36.1190, O36.1910, O36.1920, O36.1930, O36.1990, O36.5110, O36.5120, O36.5130, O36.5190, O36.5910, O36.5920, O36.5930, O36.5990, O36.8120, O36.8130, O36.8190, O36.8210, O36.8220, O36.8230, O36.8290, O36.8910, O36.8920, O36.8930, O36.8990, O41.1010, O41.1020, O41.1030, O41.1090, O41.1210, O41.1220, O41.1230, O41.1290, O41.1410, O41.1420, O41.1430, O41.1490, O42.00, O42.011, O42.012, O42.013, O42.02, O42.10, O42.111, O42.112, O42.113, O42.12, O43.011, O43.019, O43.101, O43.102, O43.103, O43.199, O43.211, O43.212, O43.213, O43.221, O43.222, O43.223, O43.231, O43.232, O43.233, O43.239, O43.811, O43.812, O43.813, O43.819, O43.91, O43.92, O43.93, O44.00, O44.01, O44.02, O44.03, O44.10, O44.11, O44.12, O44.13, O44.20, O44.21, O44.22, O44.23, O44.30, O44.31, O44.32, O44.33, O44.40, O44.41, O44.42, O44.43, O44.50, O44.51, O44.52, O44.53, O45.001, O45.002, O45.003, O45.011, O45.012, O45.013, O45.021, O45.022, O45.023, O45.091, O45.092, O45.093, O45.91, O45.92, O45.93, O46.001, O46.002, O46.003, O46.009, O46.011, O46.012, O46.013, O46.019, O46.021, O46.022, O46.023, O46.029, O46.091, O46.092, O46.093, O46.099, O46.90, O46.91, O46.92, O46.93, O47.00, O47.02, O47.03, O47.1, O47.9, O48.0, O48.1, O60.00, O60.02, O60.03, O61.0, O61.1, O61.9, O62.0, O62.1, O62.2, O62.3, O62.4, O62.9, O63.0, O63.1, O63.2, O63.9, O65.4, O65.5, O65.9, O66.0, O66.1, O66.40, O66.5, O66.8, O66.9, O67.0, O67.8, O67.9, O68, O70.0, O70.1, O70.20, O70.21, O70.22, O70.23, O70.3, O70.4, O70.9, O71.00, O71.02, O71.03, O71.1, O71.2, O71.3, O71.4, O71.5, O71.6, O71.7, O71.82, O71.89, O71.9, O72.0, O72.1, O72.2, O72.3, O73.0, O73.1, O74.1, O74.2, O74.3, O74.8, O74.9, O75.0, O75.1, O75.2, O75.3, O75.4, O75.5, O75.81, O75.89, O75.9, O76, O77.0, O80, O82, O85, O86.0, O86.11, O86.12, O86.13, O86.19, O86.20, O86.21, O86.22, O86.29, O86.4, O86.81, O86.89, O87.0, O87.1, O87.2, O87.3, O87.4, O87.8, O87.9, O88.011, O88.012, O88.013, O88.019, O88.02, O88.03, O88.111, O88.112, O88.113, O88.119, O88.12, O88.13, O88.211, O88.212, O88.213, O88.219, O88.22, O88.23, O88.311, O88.312, O88.313, O88.319, O88.32, O88.33, O88.811, O88.812, O88.813, O88.819, O88.82, O88.83, O89.09, O89.1, O89.2, O89.8, O89.9, O90.0, O90.1, O90.2, O90.3, O90.4, O90.5, O90.6, O90.81, O90.89, O90.9, O91.011, O91.012, O91.013, O91.019, O91.02, O91.111, O91.112, O91.113, O91.119, O91.12, O91.211, O91.212, O91.213, O91.219, O91.22, O91.23, O92.011, O92.012, O92.013, O92.019, O92.03, O92.111, O92.112, O92.113, O92.119, O92.13, O92.20, O92.29, O92.3, O92.5, O92.6, O92.70, O92.79, O94, O98.011, O98.012, O98.013, O98.019, O98.02, O98.03, O98.111, O98.112, O98.113, O98.119, O98.12, O98.13, O98.211, O98.212, O98.213, O98.219, O98.22, O98.23, O98.311, O98.312, O98.313, O98.319, O98.32, O98.33, O98.42, O98.43, O98.511, O98.512, O98.513, O98.519, O98.52, O98.53, O98.611, O98.612, O98.613, O98.619, O98.62, O98.63, O98.811, O98.812, O98.813, O98.819, O98.82, O98.83, O98.911, O98.912, O98.913, O98.919, O98.92, O98.93, O99.011, O99.012, O99.013, O99.019, O99.02, O99.03, O99.111, O99.112, O99.113, O99.119, O99.12, O99.13, O99.210, O99.211, O99.212, O99.213, O99.214, O99.215, O99.280, O99.281, O99.282, O99.283, O99.284, O99.285, O99.320, O99.321, O99.322, O99.323, O99.324, O99.325, O99.330, O99.331, O99.332, O99.333, O99.334, O99.335, O99.340, O99.341, O99.342, O99.343, O99.344, O99.345, O99.350, O99.351, O99.352, O99.353, O99.354, O99.355, O99.411, O99.412, O99.413, O99.419, O99.42, O99.43, O99.810, O99.814, O99.815, O99.834, O99.835, O99.840, O99.841, O99.842, O99.843, O99.844, O99.845, O99.89, Z33.1, Z33.2, Z33.3, Z34.00, Z34.01, Z34.02, Z34.03, Z34.80, Z34.81, Z34.82, Z34.83, Z34.90, Z34.91, Z34.92, Z34.93, Z36.0, Z36.1, Z36.2, Z36.3, Z36.4, Z36.5, Z36.81, Z36.82, Z36.84, Z36.85, Z36.86, Z36.87, Z36.88, Z36.89, Z36.8A, Z36.9
Diagnosis: Pregnancy Dx: SNOMED	9279009, 9899009, 14418008, 16356006, 29399001, 31601007, 34801009, 38720006, 41587001, 41991004, 43990006, 44782008, 45307008, 47200007, 57630001, 58532003, 59466002, 60000008, 60810003, 64254006, 65147003, 65727000, 69532007, 72892002, 77386006, 79290002, 79586000, 80997009, 82661006, 83074005, 87605005, 90968009, 102872000, 102873005, 102875003, 127363001, 169560008, 169561007, 169562000, 169563005, 169564004, 169565003, 169566002, 169567006, 169568001, 198624007, 198626009, 198627000, 199715003, 237233002, 237238006, 237239003, 237240001, 237241002, 237242009, 237244005, 239101008, 248985009, 281307002, 314204000, 442478007

Last updated: July 23, 2018 at 11:03 am